Year of Publication

2016

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

April Young, PhD, MPH

Committee Member

David Mannino, MD

Committee Member

Wayne T. Sanderson, PhD, MS, CIH

Abstract

Aim: To identify demographic, behavioral, and interpersonal characteristics associated with hepatitis C (HCV) serostatus disclosure among adult, rural, high-risk people who use drugs (PWUD) in Appalachian Kentucky.

Methods: Laboratory confirmed HCV antibody-positive participants (n=243), drawn from the fifth follow-up assessment of a longitudinal study of rural PWUD, completed interviewer-administered questionnaires eliciting demographic and interpersonal characteristics, risk behaviors, and information on HCV disclosure. Correlates of HCV disclosure were assessed using logistic regression.

Results: Most (69.1%) reported disclosing their HCV-positive status to at least one of their social referents (current or past sex partners, current or past injection drug use (IDU) partners, family, friends, or spouse), but few told the people with whom they inject drugs (3.8% disclosed to current, and 1.4% disclosed to past IDU partners). In multivariate analysis, adjusting for confounders and time since HCV diagnosis, male gender (AOR=0.40, 95% CI [0.20, 0.78]), older age (AOR=0.96, 95% CI [0.92, 1.00]), lifetime history of injection drug use (AOR=0.26, 95% CI [0.07, 0.99]), and lifetime history of drug treatment (AOR=0.34, 95% CI [0.18, 0.65]) were associated with decreased odds of HCV disclosure.

Conclusions: While most participants reported HCV disclosure, the almost complete absence of disclosure to current or former injection drug use partners was concerning. Although further research is warranted, it is clear that interventions are needed to encourage HCV disclosure among those most at risk of transmitting, or becoming infected with, HCV.

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